Tag Archives: SAD basics

How can I manage SAD symptoms? Part Three – medication and talking therapies

This is part three of ‘How can I manage SAD symptoms?’, where we take a look at medication and talking therapies.

Part one covered bright light therapy, which is delivered via a SAD light and is highly recommended for treating Seasonal Affective Disorder (SAD) and Winter Blues. Part two covered dawn simulators and investing in light therapy. In the fourth part I’ll cover some lifestyle factors and share a couple of ideas with you about things you can try to jolly yourself along!

I consider myself to be very fortunate that I’m one of the 85% of people for whom light therapy is effective. But that’s not to say that I don’t use other things to help me manage my symptoms. Or that there’s no hope for you, if you find that light therapy doesn’t help you.

This is the part where I’m going to ask you to bear with me! I’m not a doctor or a therapist. So I’ll point you in the direction of good quality medical information. Please do consult your doctor or a qualified professional about any symptoms you experience.

Medication

I’m aware that some people are very uncomfortable with the idea of taking antidepressant medications. Sadly the stigma that people feel about mental health prevents many from seeking the help they need. I count myself here; I had to really challenge myself to accept taking medication – read the real story.

If you have been to see your doctor about symptoms affecting your mental health, then I’d like to say a huge well done to you! It takes a lot of courage to take this first step.

Small, round, white pills coming out of a bottleWhile the ‘first line’ recommendation for SAD and Winter Blues treatment is bright light therapy, your doctor may want you to try an antidepressant medication in addition to, or instead of light therapy. 

Mind’s page on antidepressants is very thorough and accessible and of course, your doctor can also answer any questions you might have too. 

For additional personal perspectives on managing SAD with antidepressants, I would recommend chatting with people on the Lumie Forum. I’ve found that people are very open and honest about their experiences. They’re generally happy to answer questions and share tips too. There is also the facility on the site to send and receive private messages. You can also become a member of the Seasonal Affective Disorder Association (SADA), who offer peer support services by telephone and email.

Some people find that a herbal remedy called St John’s Wort can help with feelings of mild depression and anxiety. Other products in a similar category are 5-HTP, which is a pre-cursor to serotonin production.

Products like ‘Kalms’, ‘Stress-less’ and ‘Bach Rescue Remedy’ aim to help with feelings of stress. These are available in health stores and chemists, and you might find they help. However, a note of caution: herbal remedies can interact with other prescribed and non-prescribed medications, including the contraceptive pill. They won’t be suitable for people with certain conditions, so always check with your doctor.

Cognitive Behavioural Therapy (CBT) and other talking therapies

CBT is a commonly used treatment for depressive conditions (including SAD). It has a lot of support in the medical community because it has strong scientific evidence to demonstrate its effectiveness. Some studies have found it to be as effective in treating depression as antidepressants.

Again, I’m going to refer you to a Mind page for more detail, but for now, this is how they define it:

CBT is a form of talking therapy that combines cognitive therapy and behaviour therapy. It focuses on how you think about the things going on in your life – your thoughts, images, beliefs and attitudes (your cognitive processes) – and how this impacts on the way you behave and deal with emotional problems. It then looks at how you can change any negative patterns of thinking or behaviour that may be causing you difficulties. In turn, this can change the way you feel.

Your doctor may offer you CBT through the NHS. This may be delivered face to face, over the telephone or it may be an online course. You can also find private therapists on the It’s Good to Talk website, which is hosted by the British Association for Counselling & Psychotherapy (BACP).

Most services or therapists would have a chat with you before starting the therapy to ensure that CBT is the right approach for you. From this, they may recommend CBT or perhaps a blended CBT and person-centred counselling approach.

There are also some really good self-help resources available which you could use while you’re working with a CBT therapist, or you might want to just try giving it a go yourself. I’ve read and can recommend Overcoming Depression: A Self-help Guide to Using Cognitive Behavioural Techniques by Paul Gilbert and The Feeling Good Handbook by David D. Burns, M.D.

Two people, one with a bike, walking in a park in the sunshine - talking therapiesRemember that as with any therapy, only you can do the work, and you’ll get out what you put in. Sometimes CBT itself is enough to help you. Sometimes you might need to combine it with medication and/or light therapy.

Of course, sometimes it can also help just to talk to other people who live with this condition and understand where you’re coming from. I hope that you might take some comfort from looking around this site, perhaps adding your thoughts and questions. The Lumie Forum is great too. And don’t discount talking to your family, friends and colleagues – they could be a great source of support if you are willing to share with them how you’re feeling and why.

For some less formal coping strategies, head on over to part four – I hope you’re finding this series helpful.

Image credits:
Medication: http://www.freeimages.com/photo/softgel-capsule-1325982
Walking friends: http://www.freeimages.com/photo/friendship-1534626

How can I manage SAD symptoms? Part Two – dawn simulators

This is part two of ‘How can I manage SAD symptoms’, looking at another type of light therapy – dawn simulators. I’ve also discussed making the decision to invest in light therapy here.

Part one covered the main kind of light therapy that is recommended for treating Seasonal Affective Disorder (SAD) and Winter Blues – bright light therapy, which is delivered by a SAD light. In part three, I’ll cover medication and talking therapies. Then in part four, we’ll take a look at some lifestyle strategies that I hope you’ll find helpful.

Dawn Simulators

This is Lumie’s video about dawn simulators (also known as wake up lights):

There are other manufacturers of dawn simulators, but I have only had Lumie models. I use the basic model, the Bodyclock STARTER 30. However, they have a full range that give you more functionality if you want it. I use my dawn simulator every day, even in summer. I use black-out curtains to help keep a good sleep/wake cycle.

As you can see, a dawn simulator prepares your body for waking up by gradually raising the light level in your room. The artificial sunrise provides a cue for your body to reduce production of the sleep hormone melatonin and to start gradually increasing the production of cortisol, which gives you some ‘get-up-and-go’. You might find my earlier post, ‘Why do we suffer from SAD?’ interesting too.

Dawn simulators don’t reach the same light intensity as a SAD light. Although they’re great for helping you to wake up in a more natural way, they won’t treat all of your SAD symptoms.

Do dawn simulators work?

Mary Poppins dancing and singing - maybe she used dawn simulatorsI’m not going to tell you that I leap out of bed in the depths of winter à la Mary Poppins just from using my dawn simulator alone. I’ll tell you some other things I do in the fourth part of this series which helps me. What I will say is that it is a really lovely way to wake up, feeling like you’re ready to be awake. It also means your room is light and you’re less likely to have an accident from stumbling around the room in the dark! I recommend dawn simulators to absolutely everyone, regardless of whether they suffer from SAD or not.

I honestly couldn’t go back to a traditional alarm clock now. Being shocked out of sleep in the pitch black by a wailing alarm – no thanks! In my mind, it makes no sense to wake up this way because your stress response activates. Think about it – a loud noise that rips you out of sleep… Of course your body’s going to get ready to fight or flee! It’s just not a great way to start your day, is it?

My basic model has a fixed duration sunrise, sunset and alarm features. For the sunrise, you simply set your alarm for the time you want to get up. So if you set the alarm for 6.30am, it will come on very dimly at 6.00am. It then gradually brightens over 30 minutes. Other models have adjustable time periods.

There’s a back-up beeper for peace of mind, but I usually wake a moment before it goes off. When it does, it isn’t a shock because my body’s already awake – if that makes sense? More expensive models have functionality to select the sound you wake up to.

The sunset function of the dawn simulator is nice too, allowing me to wind down and the room to gradually darken as I drop off to sleep. Zzzzzz 🙂

Investing in light therapy

Are dawn simulators and SAD lights worth the investmentI appreciate that paying around £100+ for a SAD light and another £60+ for a dawn simulator seems like a lot. Personally, I would pay many times this, for the huge difference that light therapy has made to my quality of life! Being curious what this worked out at per day, I’ve done some very rough calculations:

I recently replaced the original light box I bought when I was first diagnosed, treating myself to a more powerful Lumie Brazil. So, at £295.65 in total, my two big lights and my small LED light I use at work, have cost me about £0.12 per day. This is based on using them daily for six months over 13 years. That will continue to drop as I only bought the Brazil last year.

I also replaced my original dawn simulator a few years ago. I spent £120 over 12 years. So used every day, I have paid about £0.03 per day for my lovely wake-up lights! 😀

Will light therapy work for me?

One of the main concerns when deciding whether to buy a SAD light or dawn simulator is whether they’ll work for you. If you don’t want to buy outright, you can hire SAD lights and dawn simulators, from e.g. the SAD Shop. Or, you could buy a product direct from a manufacturer, who may give you a money-back guarantee. Lumie give you 30 days and Philips give you 28 days’ free home trial. Most people will notice their symptoms improve in around a week or two. This would give you plenty of time to see if the products are helpful for you.

Giving people an experience of light therapy was behind my reason for launching the Little Light Room events. I wanted people to be able to experience it for themselves and ask me any questions.

Given that light therapy is the first line of recommended treatment for SAD and Winter Blues, I really would encourage you to invest in at least a SAD light if you can. If light therapy works for you, you’ll be amazed by the difference it makes to your quality of life.

And if you find light therapy doesn’t work for you? Well then, firstly you have my sympathies. There are other treatments you can try, such as medication and talking therapies like Cognitive Behavioural Therapy (CBT) – look out for more on these in part three.

What’s your experience with light therapy? Have you tried a dawn simulator? Have you any tips and tricks of your own to share?

Neens 🙂

Image credits:
Mary Poppins: http://www.thefancarpet.com/uploaded_assets/images/gallery/919/Mary_Poppins_10976_Medium.jpg
Coins in hand: http://www.freeimages.com/photo/coins-in-hand-1245246 

How can I manage SAD symptoms? Part One – Light Therapy

I’ve touched on how to manage symptoms of Seasonal Affective Disorder (SAD) and Winter Blues briefly in ‘SAD basics’. As promised in that post, I’m working my way through the ‘What, Why, Who, Where, When and How’ of SAD in more detailed posts. So, this is the big ‘How’. “Finally” – I hear you say?! 😉 This first post focuses on light therapy.

This turned into a really long post, so I’ve split it into four parts, to make it more digestable – although they’re still long! I’ll add links at the end to the other parts as I post them. These posts are based on my own personal experience of living with SAD; I’ll signpost you to quality information available on the web if you want to do further reading. The resources section of the site is there too.

So you know that you suffer from either SAD or Winter Blues – now what? How do you manage the symptoms so that you can get back to being you? Or a slightly more recognisable version of you, at least? 

First the bad news, to get it over with:

There is no one universal, this-will-definitely-work-for-you treatment for SAD or Winter Blues.

You can’t permanently ‘treat’ these conditions in the traditional sense; unfortunately you can’t be cured of SAD. It is really about managing your symptoms with daily treatment when you feel you need it.

OK, so now that’s out of the way – the good news! 😀

According to the SAD Association, 85% of people will find some relief of their symptoms by using light therapy regularly.

This is usually from the onset of symptoms (any time from late August) until the time their symptoms normally disappear (for many, this is often late March/early April).

What are SAD Lights/Lamps?

hands cupping sunshine - natural light therapy is best if you can get itSAD Lights/Lamps are very bright lights that simulate the level of light you would get on a clear spring morning. They are the leading method for managing SAD symptoms.

Light is measured in lux. A minimum of 2,500 lux output is recommended for treating SAD symptoms, but a brighter 10,000 lux light will enable you to sit further away, or reduce your treatment time. The newer LED lights are often a lower intensity at 2,500 lux, but they contain more blue light, so can be as effective as a 10,000 lux light.

Normal light bulbs, or even ‘daylight bulbs’, are not strong enough to treat SAD – 2,500 lux is roughly five times brighter than a well-lit office.

How do you use light therapy lights?

You can do other activities, like reading or watching TV while you’re having your light treatment. You don’t look into the light, it just needs to reach your eyes. How close you need to sit and for how long depends on the strength of your light and how severe your symptoms are.

If you like to sit further away from your light, you’ll need a longer treatment time. The manufacturer of your light will give you an idea of typical treatment time; for example the strongest and largest lights are generally 10,000 lux and take 30 minutes at 30cm (about arm’s length).

What do I use?

I have two lights. I treated myself to a new Lumie Brazil (shown in the image) last year and I love it! It is a broad spectrum light – the first I’ve had – and it is a lovely warm-toned light. My previous light for home was daylight spectrum and a stark, blue-toned light). I have my breakfast sitting in front of it. I’ve also started practising ‘The Miracle Morning‘ recently and so I do the practices at my dining table. 

Lumie Brazil light therapy lamp

At work I have a small portable LED light for top-ups or if I have missed my morning session for whatever reason. They don’t make the one I have now; it’s been replaced with the ZestMy light sits on my desk at work and is about the size and weight of a paperback novel. What’s great about this is that I can put it away in my desk drawer when it’s not in use, and if I happen to travel somewhere, I can easily take it with me.

Before I bought this light, I did consider how I’d feel about having it on my desk, with colleagues coming to see me to discuss projects. I also wondered whether the bright light would bother my team. I needn’t have worried. The light’s quite targeted and I can always switch it off if someone comes to my desk. It’s not unusual for colleagues to be interested and ask about the light. Some have even gone and bought light therapy products off the back of these conversations. 

What alternative light therapy products are there?

You can also get light therapy in the form of a visor, so you can move around while receiving light therapy, but I’ve never used these. Also, the Valkee Brain Stimulation Headset was launched a few years ago, but I have no experience of this and the SADA committee don’t believe they work so I haven’t bothered to try. I’d be interested in hearing from anyone who has used either type of product.

How long will it take for light therapy to work?

You might need to play about a bit with light therapy before you find what works best for you. It’s really worth persevering for a little while though, trying different times of the day, different distances and length of treatment.

Most people will start to feel better (more energy, improved mood) within about two weeks, but if it takes longer than this for you, don’t worry! If you’re not finding the light therapy helpful, try calling the manufacturer for some advice.

If you still find that light therapy doesn’t work for you, try not to lose hope; your doctor will be able to recommend other treatment strategies, some of which I’ll talk about in part three.

Final advice…

It’s really important that you be as consistent as you can with your light therapy – use your light every day in the months that you normally experience symptoms. This will help keep your serotonin levels on a more even keel and, together with a few other coping strategies, you should feel much more your normal self than in previous winters.

In spring and summer, a run of dull weather can bring your symptoms on again. Don’t worry – many people experience this! It would be so nice to be able to put your light away in a cupboard for six months. Unfortunately the UK’s spring and summer months seem to be becoming wetter and so it’s worth keeping your light within easy reach.

Dog enjoying some light therapy in a sunny windowAnd of course, my final piece of advice about light therapy: try to get as much natural light as you can! I know it’s hard, but if you can get out and about you’ll feel better. If you struggle with this ask a friend or family member to give you a prod! Sit by windows if you can too – it all helps.

I hope that you will have found this post helpful, but as always, I welcome your feedback and comments. What’s your experience of light therapy? Have you tried a visor or the Valkee in-ear system; what did you think? Is there anything missing from this post that you’d like me to include?

The next part of this post will look at dawn simulators; they’re great little inventions that help get you out of your pit in the morning!

Take care

– Neens –

Image credits
Hands up: http://www.freeimages.com/photo/hands-up-1537812
Laurent: http://www.freeimages.com/photo/laurent-1373052
L
umie Brazil: http://www.lumie.com/collections/light-therapy-sad/products/brazil

Why do we suffer from Seasonal Affective Disorder (SAD)?

Hello there! I hope you’re well and getting into the swing of your light routine? Finally, here is instalment number two of my ‘who, why, what, where, when and how’ of Seasonal Affective Disorder (SAD) and Winter Blues. It’s another long one, but I hope you’ll find it interesting! 😀

In this post I’ll be covering a couple of the accepted theories of why people get SAD and Winter Blues / Winter Depression. This is my own understanding, based on what I’ve read over the years and a little background reading I’ve done for this post. It’s taken me quite a while to write, as I keep changing my mind what to put in! I don’t want to overwhelm you with too much info, but wanted to give you enough too. As always, do let me know what you think?

Do we actually know what causes SAD and Winter Blues?

In short, no. The first thing to say is that nobody seems to really know what causes SAD and Winter Blues! There’s a lot of theories, but it’s likely that there’s a complex interplay of factors that determine whether an individual develops SAD or not.

The most commonly held theory is that a lack of exposure to daylight in the late autumn to early spring months affects the brain’s production of the hormone melatonin and the neurotransmitter serotonin.

The body has an internal body clock, known as the circadian rhythm. It regulates sleep/wake cycles, appetite, digestion, mood and many other functions. This explains why SAD affects us in so many different ways.

What we have to remember is that we are animals and in evolutionary terms our bodies haven’t caught up with the lifestyles we’ve adopted as humans. Before we learned to artificially light our homes, people went to bed when it became dark and woke when the sun rose. They also spent a lot more time outdoors and had more physical jobs.

 

SAD and melatonin

The brain responds to decreased light by increasing production of the hormone melatonin, which signals to the body that it’s time to sleep. In the morning, when light reaches the eyes, melatonin levels begin to decrease and the hormone cortisol is released. This gives us the get-up-and-go that we need to start the day.

Red traditional alarm clock - these can be difficult for SAD sufferersIn the depths of winter, when many of us need to get up while it’s still dark, the body hasn’t received the correct signals to wake up. This is why it can be a real wrench to get up and you may feel shocked out of sleep by a traditional alarm clock – your body simply isn’t ready to be awake! When you think about it, this way of waking is likely to activate your fight or flight response. You wake up stressed before you’ve even started your day! A dawn simulator can help with this, waking you up in a more natural way.

But the problem isn’t only to do with waking. On very dull days, your levels of melatonin can stay high throughout the day, leading to those feelings of lethargy and sleepiness that you might recognise all-too-well. Before I was diagnosed with SAD, I would return from college and want to go straight to bed – I couldn’t keep my eyes open!

SAD and serotonin

The neurotransmitter, serotonin, is also thought to have a key role to play in SAD, as it appears to in other types of depression. Researchers have found that levels of serotonin can vary from day-to-day and across the year, with levels markedly lower in winter. People with lower levels of serotonin appear to be more likely to experience symptoms of all kinds of depression.

Reading about how to increase serotonin in the human brain without drugs (Dr. Simon N. Young, 2007), this theory makes sense to me. If you’re anything like me, in winter you’ll be less likely to go outside at lunchtime, or whenever. Often eating at my desk means I move my bones less, get less natural light and I’m probably eating stodge, too. Carb cravings are a common symptom. I mean – who really fancies a salad in the middle of winter? Certainly not me! Haha – yes, yes, I’m aware that I don’t always follow my own advice! 😀

So, if light, exercise and a healthy diet are major natural ways of increasing serotonin production, then it would seem to follow that not doing/having these things may cause you to feel rubbish. At least, that’s how I understand it! 

Some further reading

As always, if you haven’t already, I’d recommend you have a look at the following excellent articles about SAD. They explain a bit more of the why in more medical terms than I have done:
NHS
Mind

If you’re interested in doing a bit more digging around into theory, here’s a few other theories that caught my eye:

People who suffer from SAD have an ‘unhelpful’ way of controlling serotonin –
Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with Seasonal Affective Disorder – Mahon et al (2014)

People who suffer from SAD may have retinal sensitivity anomalies –
Evidence of a Biological Effect of Light Therapy on the Retina of Patients with Seasonal Affective Disorder – Marie-Pier Lavoie,Raymond W. Lam,Guylain Bouchard,Alexandre Sasseville,Marie-Claude Charron,Anne-Marie Gagné,Philippe Tremblay,Marie-Josée Filteau,Marc Hébert (2009), Biological Psychiatry, Elsevier

People who suffer from SAD have lower levels of cortisol production in winter –
Seasonal differences in the diurnal pattern of cortisol secretion in healthy participants and those with self-assessed seasonal affective disorder – Thorn, Lisa and Evans, Philip D. and Cannon, Anne and Hucklebridge, Frank and Clow, Angela (2011), Psychoneuroendocrinology

An ongoing debate…

There’s a lot of debate still ongoing, though, as many of the theories don’t give absolute or satisfactory answers. So for example, suppressing melatonin doesn’t ‘cure’ SAD. Anti-depressants don’t work for everybody. Light therapy works for around 85% of people. It really does seem that individual differences can play a big part. So you may be more at risk of developing SAD if you or your family have a history of depression, or if you’ve been under chronic or sudden stress. If you suffer from depression that isn’t seasonal, it can feel worse in the winter.

Having said that, there does seem to be strong evidence to support the theories surrounding melatonin and serotonin having a key role to play. Correspondingly, there’s also strong evidence to support light therapy. If you want to do some more reading still, have a look at Lumie’s page of research abstracts. SADA members also receive monthly e-bulletins and longer newsletters three times per year which contain scientific news on SAD and Winter Blues.

I hope that this will have been a helpful post for you. Do you think there’s anything I need to add? What other theories have you read?

Take care,

– Neens –

Image credit
Alarm clock: http://www.freeimages.com/photo/alarm-clock-1621256

SAD basics – where to start?

Seasonal Affective Disorder (SAD) and its milder form, Winter Blues (also known sometimes as Winter Depression, or medically as Sub-syndromal SAD) affects over a quarter of the UK population*. Does that surprise you? It did me! So even if you don’t suffer from one of these conditions yourself, it’s highly likely that someone close to you does. Read on to help you get up to speed with some SAD basics.

Eeyore looking sad and Tigger bouncingOne of my favourite ways to describe SAD is through these little fellas; Tigger and Eeyore. I tried out this analogy on a friend once and he loved it!

SAD is thought to be caused by a lack of light. During the late autumn and winter months, the shorter days and lack of sunlight can affect chemical levels in your brain, making you feel down, irritable, lethargic and unsociable – a bit like Eeyore. But in the spring and summer months you feel more ‘yourself’, and even in the depths of winter, a sunny day can bring out the Tigger in you! Some people even experience mania-type symptoms once spring comes round, known as Hypomania. That’s probably where everyone’s energy comes from for the big spring-clean! 😉 For a bit of fun, I found this quiz to identify which Winnie the Pooh character you’re most like – I turned out to be Kanga! 🙂 

SAD basics – the facts

SAD is a type of depression. I know some people aren’t comfortable with this description, but medically, they do sit on the same scale. What differentiates SAD from other types of depression is that it has a very definite seasonal pattern. You normally will have experienced symptoms in a particular season that disappear reliably in another season for three consecutive years before you would be diagnosed with SAD.

There are also other, rarer types of SAD that people suffer from, such as Summer SAD. This site mostly addresses Winter SAD and Winter Blues, as the most common form of the condition and the kind that I suffer from. Other tell-tale differences are that unlike ‘classic’ depression, you tend to want to sleep and eat more (usually carbs) when you suffer from SAD, whereas with ‘classic’ depression, people often lose their appetite and find it difficult to sleep. This is a very individual condition though, so it’s always worth checking any symptoms with your doctor, rather than self-diagnosing.

For interest, though, you might be wondering what are the other symptoms of SAD? Well, I mentioned some of the main ones already, but a few of the most common others include:

  • Bread with a heart cut out of the middleDisturbed sleep patterns 
  • Loss of interest in things you normally enjoy and social withdrawal
  • Craving carbohydrates and sweet foods (comfort food!)
  • Loss of libido
  • Anxiety
  • Difficulty concentrating/feeling fuzzy-minded
  • Lowered immune system in winter

Managing SAD

There isn’t a ‘cure’ for SAD or Winter Blues. However, many people can successfully manage their symptoms using light therapy. The SAD Association estimates that this will work for around 85% of sufferers. Your doctor may also recommend treatment with medication and talking therapies. 

You’d normally use light therapy daily from the onset of your symptoms, often from around September until April when the daylight hours lengthen. The treatment involves exposure to a bright SAD light that simulates the level of light you would get on a bright spring day. How long you need to use the light for depends on the severity of your symptoms and the strength of the light. 

I whole-heartedly recommend giving light therapy a go – I have managed my symptoms since being diagnosed using a SAD light and a dawn simulator, which wakes me gently with light in the morning. I recommend dawn simulators to everyone, regardless of whether or not they suffer from SAD – they’re such a lovely way to wake up! 🙂 

I hope this introduction to some SAD basics has been helpful to you. I will write some more in-depth posts, but if you want more information on SAD and Winter Blues before then, please have a look at this NHS page and SADA’s website.

If you’re able to attend events in Newcastle upon Tyne, you can get a taste of what light therapy is all about at Little Light Room events.

What Winnie the Pooh character do you identify with? Is there something in particular that you’d like me to cover in a future post?

Take care!

-Neens x-

*http://www.theweathercompany.com/SAD%20research%20UK

Image credits:
Tigger and Eeyore: http://www.chicagonow.com/cheaper-than-therapy/2013/11/are-you-a-tigger-or-a-eeyore/
Bread: http://www.freeimages.com/photo/love-food-1306422